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Nexplanon™

What is Nexplanon™?

Nexplanon (which has replaced Implanon, an older version of the device) is a small, thin, implantable type of birth control that releases hormones.  It is a flexible plastic rod the size of a matchstick that is put under the skin of your arm and is effective for up to three years. 

Nexplanon prevents pregnancy in several ways. The most important way is by stopping release of an egg from your ovary. It  also changes the mucus in your cervix, which acts as a barrier to sperm reaching and fertilizing an egg. In addition, it changes the lining of your uterus.  It is important that you continue your routine annual exams and Pap smears while you use Nexplanon.

Nexplanon must be replaced every three years.  Your healthcare provider can remove the implant at any time. If you want to become pregnant after removal, your ability to become pregnant may return quickly. If you don't want to get pregnant, you should begin another birth control method right away.

implanon.jpgHow is Nexplanon inserted?

Nexplanon insertion is a minor procedure using a local anesthetic. It usually takes just a few minutes, and is performed during a normal office visit. During the procedure, you may feel a pinching sensation, similar to receiving a shot or injection.  

Most women are not able to see Nexplanon after it has been inserted.  You should be able to feel where the implant is by gently pressing on your skin in the area where it was inserted. To reduce the risk of infection, it is advised to avoid touching the site of insertion until it has healed

What about removal?

Nexplanon must be removed by the end of the third year. It is removed by making a small incision in your arm after numbing the area with local anesthetic.

If you wish to continue using Nexplanon at the end of three years, a new implant can be inserted in the same place as the old one during the same procedure. Nexplanon can be removed at any time if pregnancy is desired.

Will the insertion or removal of Nexplanon leave a scar?

There is a slight risk that you will get a scar from insertion or removal of Nexplanon.  Women with a family history of developing keloids (raised, thickened scars) are more likely to scar.

Who can use Nexplanon?

Nexplanon is a progestin-only method of birth control. Because it does not contain estrogen, your healthcare provider may recommend it even if you cannot use estrogen.  It can also be used by women who are breastfeeding.

Do not use Nexplanon if you:

  • Are pregnant or think you may be pregnant
  • Have, or have had serious blood clots, such as blood clots in your legs (deep venous thrombosis), lungs (pulmonary embolism), eyes (retinal thrombosis), heart (heart attack), or head (stroke)
  • Have unexplained vaginal bleeding
  • Have liver disease
  • Have breast cancer, now or in the past
  • Are allergic to any ingredient in Nexplanon

Tell your clinician if you have ever had any of the conditions just listed and to determine if Nexplanon is an appropriate form of contraception for you.

What are the benefits of using Nexplanon?

  • Nexplanon is more than 99% effective.  The chance of getting pregnant is less than 1 pregnancy per 100 women. 
  • Can have fewer hormonal ups and downs due to the steady level of hormones
  • Discreet and long lasting

What are the disadvantages of using Nexplanon?

  • Some women find that they have irregular and unpredictable bleeding with Nexplanon.
  • The effectiveness of Nexplanon may be decreased for overweight women or women who are taking certain medications.
  • Like other types of hormonal birth control, Nexplanon does not protect against infection from HIV or other sexually transmitted diseases.

What are the side effects and risks of using Nexplanon?

The most common side effect of Nexplanon is a change in your menstrual periods. Your menstrual period may be irregular and unpredictable while using Nexplanon.  Other side effects may include:

  • Headache
  • Vaginitis (inflammation of the vagina) or vaginal discharge
  • Weight gain
  • Acne
  • Breast pain
  • Abdominal pain
  • Painful periods
  • Mood swings, nervousness, or depression
  • Nausea or dizziness

What are the potential risks?

Potential risks include:

  • Complications of insertion and removal may include pain, swelling, bruising and infection.  The implant can shift or break over time, making removal difficult.  In some cases, the implant can work its way out.  In rare cases, Nexplanon can cause permanent scarring.
  • If you become pregnant (your risk of pregnancy is less than 1%), there is a slightly increased risk of having a pregnancy outside the uterus (known as ectopic pregnancy).
  • Complications from the interaction with other medicines can occur. Tell your healthcare provider about any medicines you are taking, or intend to take, including over-the-counter medicines, herbal supplements, and prescription medicines.
  • Ovarian cysts (these rarely require surgical intervention)
  • Thrombosis (blood clots)

How do I get Nexplanon?

Schedule an appointment with your medical provider or with Hall Health to discuss your birth control options and learn whether Nexplanon is appropriate for you given your medical history.

Your medical provider will provide instructions to you about when to schedule an appointment for insertion of the device.  The timing of insertion is important and quite exact:

  • If you're not on hormonal contraceptives, you'll need to come in between the first and fifth day of your menstrual cycle. (Day one is the first day of menstrual bleeding.)
  • If you are switching from combination (estrogen and a progestin) hormonal contraceptive, like the pill, the ring, or the patch, you'll need to schedule anytime within seven days of taking the last active pill or removing the patch or ring.
  • If you'll be switching from a progestin-only method, like progestin-only pills (the mini-pill) or Depo Provera, come in for the insertion any day during the active pill cycle (but important not to skip any dose) or on the day the next Depo Provera shot would be due.
  • Within five days of a first trimester abortion or miscarriage.
  • If you've recently given birth and are exclusively breastfeeding, you'll need to schedule your appointment after the fourth week following the birth.

Additional resources

Bedsider.org provides information about many different birth control methods

Planned Parenthood's website offers information on the effectiveness of different kinds of birth control methods

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information.

 

Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014